Philosophy Ethics and Humanities in Medicine最新文献

{"title":"Exploring attitudes toward euthanasia in Iranian healthcare providers: a systematic review of influencing factors.","authors":"Nazanin Fard Moghadam, Azin Hassani, Loghman Khaninezhad","doi":"10.1186/s13010-025-00186-y","DOIUrl":"10.1186/s13010-025-00186-y","url":null,"abstract":"<p><strong>Background: </strong>Euthanasia is a polarizing topic in healthcare, particularly in Iran, where Islamic principles emphasizing the sanctity of life shape ethical perspectives. Understanding the attitudes of Iranian healthcare providers toward euthanasia and the factors influencing these views is critical, given the cultural and religious context. The primary objective of this study was to systematically identify and synthesize the key factors influencing healthcare providers' attitudes toward euthanasia in Iran.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, Magiran, and SID databases up to March 10, 2025. Inclusion criteria encompassed observational studies reporting quantitative data on euthanasia attitudes among Iranian healthcare providers. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Joanna Briggs Institute tools. Due to heterogeneity in study designs and measurement tools, a narrative synthesis was performed.</p><p><strong>Results: </strong>Of 595 identified records, 36 studies involving 7,790 participants met inclusion criteria. Attitudes toward euthanasia were predominantly cautious or negative, with stronger opposition among older providers, females, and those with deep religious beliefs. Younger age, male gender, clinical experience, and exposure to terminal patients correlated with more positive attitudes. Religious and cultural factors, particularly Islamic teachings, were significant barriers to acceptance, while urban settings and higher education were linked to neutral or mixed views.</p><p><strong>Conclusion: </strong>Iranian healthcare providers' attitudes toward euthanasia reflect a complex interplay of religious, cultural, and professional influences. These findings underscore the need for enhanced palliative care and ethical training in Iran's healthcare system to address end-of-life dilemmas while respecting cultural boundaries.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"21"},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' perception of medical care in the hospital environment: the reasons of non-hospitality.","authors":"Laura Marques Castelhano, Gilberto de Araujo Guimarães, Isabel Baptista","doi":"10.1186/s13010-025-00176-0","DOIUrl":"10.1186/s13010-025-00176-0","url":null,"abstract":"<p><strong>Background: </strong>The medical care provided by the physician is an important part of the hospital scene and the action of caring. Assessments of the physician-patient meeting are based on welcome and the physician's ability to be perceived as hospitable by the patient. By definition, to be hospitable is to have the ability to welcome, care for, reassure, and be courteous, respectful, and trustworthy. This article aims to understand patients' perceptions of medical care perceived as not hospitable, characterized by a lack of care and welcome, in a hospital environment, based on a complaint's website.</p><p><strong>Method: </strong>The research method used was qualitative analysis and the research strategy was documentary research. The data were collected on a complaints registration platform. The theoretical framework used was the theory of Hospitality. The study selected, coded, and categorized the complaints of 127 patients at the 09 most renowned private hospitals in Brazil. The Voyant tools assisted in the textual analysis of complaints while coding classified them into categories.</p><p><strong>Results: </strong>After evaluating the reasons and elements of the complaint, the following was analyzed the encounter characterized as hostile and inhospitable and the attitudes perceived by the patients were grouped into what was defined as \"the 4 D's of non-hospitality\": dehumanization, disregard, dereliction of duty, and disability. Each of the attitudes was characterized by the physician's behavior and the sensations, emotions, and feelings triggered in the patient.</p><p><strong>Conclusions: </strong>Patients' perception of the not hospitable encounter may be hostile or inhospitable. The physician's attitude is an important criterion for evaluating the encounter. The physician's attitude and the form of care are key factors in a culture focused on hospitality in the hospital environment. Hostile and inhospitable attitudes affect the physician-patient relationship and may compromise the patient's well-being.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"9"},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The linguocultural concept of /pandemic/пaндeмия in Chinese, English, and Russian linguistic consciousness.","authors":"Yanlei Ge","doi":"10.1186/s13010-025-00168-0","DOIUrl":"10.1186/s13010-025-00168-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As a major public health event, the pandemic has been widely discussed across various academic disciplines. In the field of humanities, most pandemic-related studies use introspective methods such as description and interpretation, indicating to some extent subjective and one-sided conclusions. In this paper, pandemic-related linguistic information and linguistic big data serve as research materials. Based on the theory of linguocultural concepts, the study employed natural language processing methods such as the analysis of word frequency and collocation co-occurrence to conduct an in-depth empirical study of /pandemic/пaндeмия as a linguocultural concept in Chinese, English, and Russian linguistic consciousness from diachronic and synchronic perspectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the basic linguocultural theories, this study provides a comprehensive interpretation of the etymological data on the conceptual words /pandemic/пaндeмия, its lexical interpretation, and high-frequency words and co-occurring collocations related to the pandemic in Chinese, English, and Russian text corpora in Sketch Engine. The paper also analyzes reports from the mainstream media (People's Daily Online, BBC, and TASS) to depict and explain in detail the aspects of linguocultural concepts. The historical trends of the pandemic-related concepts in the three languages were examined by observing word frequency changes through Google Book Viewer. This hybrid empirical research framework, which combines cultural concepts with linguistic big data technology, made it possible to explore the content of linguocultural concepts in a more objective, comprehensive, and profound way.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study revealed that: 1) In terms of etymology, the Chinese character (yi, pandemic) implies a belief that pandemics were created by ghosts and gods to render people immobile. The character (yi, pandemic) is also related to the concept of a fight. The English and Russian analogues (pandemic/пaндeмия) denote the same phenomenon: a disease that spreads widely among the whole population. 2) For more than 100 years since the twentieth century, pandemics have been a more significant part of Chinese consciousness than they have been in English and Russian cultures. 3) During the COVID-19 Pandemic of 2020-2023, the total number of news reports on (yi, pandemic) in Chinese was higher than the total number of news reports in English and Russian. This indicates that Chinese media tend to pay much more attention to the COVID-19 pandemic than media in the United Kingdom and Russia in all aspects. 4) China emphasizes the containment of domestic outbreaks through stringent, proactive, and comprehensive measures, including quarantine protocols, extensive testing campaigns, and evidence-based treatment strategies. On the contrary, the United Kingdom and Russia are more concerned with the global outcomes of the pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Co","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"13"},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empathy in technologically mediated patient-provider communication: a phenomenological and postphenomenological exploration.","authors":"Elisabeth Assing Hvidt, Finn Olesen","doi":"10.1186/s13010-025-00172-4","DOIUrl":"10.1186/s13010-025-00172-4","url":null,"abstract":"<p><strong>Background: </strong>This theoretical paper aims to explore empathy in the context of technologically mediated patient-provider communication, specifically within the context of video- and telehealth consultations. Over the past few decades, empathy has been recognized as a vital component of high-quality patient care, often prioritizing the cognitive over the emotional dimensions of empathy. As healthcare increasingly embraces digital communication technologies, including video consultations, the dynamics of empathy in clinical encounters are altered. With this paper we explore the pertinent question: how do new digital communication modalities impact on empathy and its different dimensions?</p><p><strong>Methods: </strong>To address the above question, we move beyond clinical and applied empathy frameworks instead integrating insights from two related philosophical traditions. First, the classical phenomenological understanding of empathy (represented primarily by Edith Stein) as embodied intuition. Second, the postphenomenological philosophy of technology, represented by Don Ihde and not least inspired by Maurice Merleau-Ponty's phenomenology of embodiment. We apply these theoretical frameworks to empirical analyses of video consultations in general practice and telemedical encounters between chronic obstructive pulmonary disease (COPD) patients and specialist telenurses.</p><p><strong>Results: </strong>Our analysis demonstrates that even though video consultations do not allow for the same level of \"fine-tuned\" body-mediated sensory input, a whole-body empathetic experience can nevertheless be established through (1) the audio-visual sensory impressions that are being mediated by the technology, (2) our whole-body interpretations of this information and (3) our shared experiences of a lifeworld that we actively orient ourselves towards. These experiences may lead to empathetic communication and helping actions that draw on both emotional, intuitive and cognitive dimensions in a holistic manner.</p><p><strong>Conclusion: </strong>Combining theoretical insights from phenomenology and postphenomenology with empirical telehealth analyses, we demonstrate how empathy is both reconfigured through technological mediation and sustained as an embodied, intersubjective practice. We thus conclude that empathetic care practices can be established in technologically mediated encounters through bodily intentionality where our bodies and minds are unified in understanding and connecting with other persons, even though we are not in the same physical space. We propose a theoretical bridge, connecting classical phenomenology and postphenomenology in the context of empathy in technologically mediated patient-provider communication. This bridge is grounded in Merleau-Ponty's conception of whole-body perception and the lifeworld whether through physical proximity or digital interaction.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"11"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress among healthcare professionals in long-term care settings: a scoping review.","authors":"Floor Vinckers, Elleke Landeweer","doi":"10.1186/s13010-025-00171-5","DOIUrl":"10.1186/s13010-025-00171-5","url":null,"abstract":"<p><strong>Aim: </strong>To explore the body of knowledge available regarding the moral distress of healthcare professionals in long-term care settings, focusing on influencing factors and strategies to cope with moral distress.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Methods: </strong>This scoping review follows the guidelines of the PRISMA-ScR protocol (Tricco et al. 2018) Searches were done using a strategy that included MeSH terms and free text terms.</p><p><strong>Data sources: </strong>Data sources were PubMed, CINAHL, Psychinfo and Embase. Searches were done in October 2023 without any date restrictions.</p><p><strong>Results: </strong>Eight articles were included in this review. Moral distress can impact the wellbeing of healthcare professionals. Influencing factors of moral distress of health care professionals appeared to be lack of resources, lack of communication and incongruence with colleagues. Strategies to cope with moral distress were talking about ethical issues with others, receiving support from colleagues and managers, and seeking support from outside the team or organization. Individual healthcare professionals relied on their personal characteristics or their professional identity and used rationalization, distancing themselves or acceptance of the situation to cope with their moral distress.</p><p><strong>Conclusion: </strong>Moral distress of healthcare professionals in long-term care settings appears not differently experienced than moral distress among healthcare professionals in other healthcare settings. This can be beneficial in learning from each other, but also raises the question whether moral distress is too broadly defined.</p><p><strong>Impact: </strong>This review addressed the scope and experiences of moral distress in long-term care settings. Future research can contribute to further insight into if and how specific features of long-term care are of influence on moral distress and formulate tailored strategies to lessen moral distress.</p><p><strong>Reporting method: </strong>PRISMA-ScR.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"8"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics in aesthetic practice: results from a survey of medical doctors attending aesthetic medicine programs in Italy.","authors":"Andrea Margara, Francesca Arrigoni, Emanuele Bartoletti, Loredana Cavalieri, Nadia Fraone, Mario Mariotti, Nadia Tamburlin, Laura Tanzini, Gloria Trocchi, Franco Grimolizzi, Antonio Gioacchino Spagnolo","doi":"10.1186/s13010-025-00169-z","DOIUrl":"10.1186/s13010-025-00169-z","url":null,"abstract":"<p><strong>Background: </strong>Within a rapidly evolving digital age in which social media plays a key role, the number of aesthetic medicine procedures performed globally is increasing.</p><p><strong>Methods: </strong>Physicians who participated in training courses in aesthetic medicine in Italy run by two different medical societies SIME (International School of Aesthetic Medicine Carlo Alberto Bartoletti Foundation) and Agorà (Post-Graduate School of Aesthetic Medicine Agorà), completed a survey (November 2023 - January 2024) to assess their viewpoints on ethics in aesthetic medicine and findings combined.</p><p><strong>Results: </strong>Of 452 physicians, 72.6% - 88.2% strongly agreed about the importance of maintaining up-to-date aesthetic medicine knowledge, protecting patient confidentiality, appropriate patient communication, prioritizing patient care and safety, respecting patient dignity and privacy, and obtaining informed consent. Around half of the respondents strongly agreed with correlations between social media (including the use of filters, idealized photos, and the constant sharing of content for personalized feedback) and psychological dysfunctions/body dissatisfaction, and that physicians should examine patients with highly filtered photographs for warning signs and unrealistic expectations. Approximately 15.4% - 55.0% strongly agreed with the importance of focusing on the patient's best interest, not performing procedures on those with unrealistic expectations, letting patients decide who to involve in consultations, education in key ethical principles in aesthetic medicine (including patient autonomy and self-determination), submitting experimental aesthetic procedures to a territorial ethics committee, and obtaining informed consent from adolescents for their procedures (as well as their parents/caregivers). 43.0% - 52.0% strongly disagreed that it was unnecessary to communicate all treatment information to patients, hear and respect patient opinions, or involve patients in decisions. One-third of respondents reported previously encountering ethical issues for treatment.</p><p><strong>Conclusion: </strong>In a survey of physicians focused on ethics in aesthetic medicine, most strongly agreed with key ethical principles in aesthetic medicine; however, more formal education/training was required to highlight the importance of patient autonomy and self-determination principles, involving patients in decisions, focusing on the patient's best interest, hearing/respecting patient opinion, avoiding procedures on those with unrealistic expectations, communicating all treatment aspects to patients, letting patients decide who to involve in consultations, and understanding the negative impact of social media on patients.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"12"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation into mental illness and its comorbidities from the perspective of supervenience physicalism.","authors":"Ping Yang, Xinyue Zhang, Hongwen Song, Xiaochu Zhang","doi":"10.1186/s13010-025-00174-2","DOIUrl":"https://doi.org/10.1186/s13010-025-00174-2","url":null,"abstract":"<p><p>The exploration into the origin of human spirituality has always been a hot spot with many unsolved questions in the philosophy of mind, and issues concerning mental illness and its comorbidities are still unclear. In the 1970s, Donald Davidson first proposed anomalous monism with the supervenience concept, a theory that both insists on physicalism and transcends traditional reductionism. This theory provides solid and accessible proof for perceiving the mind-body relationship of spiritual origin in a non-reductionist approach. This paper develops arguments in two aspects. First, three principles of anomalous monism are employed to explore the origin of mental illness. Second, the comorbidity of mental illness is explained with the help of the supervenience theory.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"10"},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptualizing resilience in public health: a philosophical approach.","authors":"Jishnu Pawan K, Mala Ramanathan","doi":"10.1186/s13010-025-00173-3","DOIUrl":"https://doi.org/10.1186/s13010-025-00173-3","url":null,"abstract":"<p><strong>Background: </strong>The initial inquiry into the concept revealed its usage as a boundary object and how this facilitated its interdisciplinary utilization. The same feature enabled the shift to literature within other disciplines and then identify its conceptualization in them. This led to the understanding that though many disciplines have used the term resilience to describe a phenomenon with a general understanding of \"bouncing back to original position\", its multi-disciplinary usage has added a lexical ambiguity to the term. The purpose of the study is to utilize this broad and overlapping nature of resilience to identify those elements, models or pathways that might enable conceptualizing resilience in the context of public health. In this process we uncover the underlying philosophical elements that converge or diverge with the whole conceptualization process of resilience in the discipline of public health.</p><p><strong>Methods: </strong>We used a modified integrated review of the body of literature while also reflecting on how the concept of resilience has evolved from a narrow, \"Substance Metaphysics,\" \"Reductionist\" phenomenon to a more expansive, \"Multi-Dimensional,\" \"Intersectional,\" and \"Dynamic phenomenon.\" Afterwards, existing philosophical theories that converged or diverged with the conceptualization process were used to further validate the entire process that resulted in the definition of resilience in the context of public health emergencies.</p><p><strong>Results: </strong>The critical evaluation of existing literature led to the identification of two patterns by which resilience has been conceptualized across disciplines. One on the basis of engagement with acute or enduring crisis resulting in trajectories that enables stability or growth and transformation. Another on the basis of the levels at which it was conceptualized by various authors from multiple disciplines. The two approaches were later critically evaluated so as to conceptualize resilience in the context of public health.</p><p><strong>Conclusion: </strong>An integrated response to the crisis may be necessary to preserve people's health and the health of communities in order for them to be resilient. Resilience in public health is a result of the successful engagement of relevant stakeholders responsible for health preservation to current and emerging health inequalities that places them in enabling trajectories of sustenance or growth leading to the development of potential capabilities that are sensitive to diverse health disparities.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"7"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the shadows: obstacles, consequences, and challenges of information opacity in healthcare systems.","authors":"Majid Alizadeh, Nazila Azizi, Samireh Mahdavi, Fouad Baghlani","doi":"10.1186/s13010-025-00170-6","DOIUrl":"https://doi.org/10.1186/s13010-025-00170-6","url":null,"abstract":"<p><strong>Introduction: </strong>Information transparency in healthcare systems is critical for ensuring public trust, enhancing service quality, and reducing costs. However, many countries face significant challenges concerning information opacity, which leads to inequality, discrimination, and increased risks for patients and healthcare providers. This study aims to explore the obstacles, consequences, and challenges of information opacity in healthcare systems, along with proposing solutions for improvement.</p><p><strong>Method: </strong>This review synthesized findings from scientific literature, including articles, reports, and governmental sources, to investigate how the lack of information transparency affects healthcare performance and public trust. A comprehensive search was conducted across major databases such as PubMed, Scopus, and Google Scholar, utilizing relevant keywords. Selection criteria focused on the relevance, quality, and timeliness of the sources, leading to a critical analysis of the extracted data through thematic synthesis.</p><p><strong>Findings: </strong>The study identifies several key consequences of information opacity, including a decrease in public trust, reduced service quality, increased corruption, and heightened healthcare costs. The findings align with existing literature that highlights the importance of transparency for effective decision-making and accountability in healthcare systems. Furthermore, obstacles to achieving transparency were identified, such as difficulties in accessing necessary information, privacy concerns, commercial interests, and the need for systemic reforms in healthcare financing.</p><p><strong>Discussion: </strong>The implications of this study underscore the necessity for clear policies and procedures regarding information dissemination in healthcare. The proposed framework for improving transparency includes establishing robust communication channels, enhancing public access to information, fostering a culture of accountability, and leveraging emerging technologies like blockchain and artificial intelligence. Addressing these challenges is essential for building trust and improving healthcare outcomes.</p><p><strong>Conclusion: </strong>Enhancing information transparency within healthcare systems is vital for improving public trust and service quality. This study provides a foundational framework for policymakers to implement necessary changes, promoting a more equitable and efficient healthcare environment. Future research should focus on evaluating the effectiveness of these proposed measures in diverse healthcare contexts, particularly by integrating theoretical frameworks such as stakeholder theory and institutional theory.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"6"},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioethical evaluation of methylphenidate and atomoxetine for pediatric ADHD and cognitive enhancement.","authors":"Enrique Burguete, Luisa Peydro, Ignacio Ventura","doi":"10.1186/s13010-025-00167-1","DOIUrl":"10.1186/s13010-025-00167-1","url":null,"abstract":"<p><strong>Background: </strong>This article presents a bioethical analysis of the use of Methylphenidate and Atomoxetine, exploring their roles as cognitive enhancers and therapeutic agents for Attention Deficit Hyperactivity Disorder (ADHD).</p><p><strong>Methods: </strong>The analysis centers around the principle of non-maleficence, examining the ethical implications of causing harm in the pursuit of cognitive enhancement and therapeutic benefits. It delves into the blurred boundaries between therapy and enhancement and the challenges of defining \"necessary harm\" in these contexts.</p><p><strong>Results: </strong>When used for cognitive enhancement rather than therapeutic purposes, methylphenidate challenges the concept of \"necessary harm,\" raising ethical concerns about seeking improvement at the cost of potential adverse effects. The very notion of neurocognitive enhancement remains controversial in the absence of a clinical pathology. In pediatric ADHD, there is a significant lack of long-term data on both therapeutic benefits and adverse effects beyond 30 weeks of treatment. Clinical trials have highlighted safety concerns, as methylphenidate has been linked to sleep disturbances, anorexia, nervous conditions, and, in rare cases, cardiac events. Additionally, exposure during pregnancy may pose risks of congenital malformations. While atomoxetine generally has minor side effects, occasional reports of suicidal tendencies warrant caution.</p><p><strong>Discussion: </strong>The article discusses the philosophical and ethical underpinnings of human nature, individual autonomy, and the pursuit of enhancement, drawing on historical perspectives from figures like Julian Huxley and contemporary transhumanist ideals.</p><p><strong>Conclusion: </strong>The study advocates for a cautious approach to cognitive enhancement, emphasizing the preservation of the individual's well-being over performance gains. In the context of ADHD treatment, it calls for an ethical examination of the long-term effects of Methylphenidate and Atomoxetine use in children and adolescents, recommending a preference for behavioral treatments when possible. Pediatric ADHD: There is a notable scarcity of data regarding the prevalence of therapeutic benefits and/or adverse effects in treatments exceeding 30 weeks. Furthermore, clinical trials concerning its safety and the lack of long-term data compromise the principle of non-maleficence, as we know that the use of Methylphenidate can lead to sleep disorders, anorexic conditions, nervous disorders, and has occasionally been associated with cardiac events. It also has effects on pregnancy that can lead to malformations in offspring. And although the unwanted effects associated with atomoxetine are generally minor, suicidal tendencies have been occasionally reported.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"5"},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}